A new study shows that when children get vaccinated against seasonal influenza, the entire community can benefit.

The study found that people living in communities where about 80 percent of the children were vaccinated against the seasonal flu were much less likely to contract seasonal influenza, even if they had not gotten vaccinated.

The study was conducted in religious colonies in Canada that have limited contact with the surrounding communities. The results offer clinical evidence that immunizing school children can be effective if preventing flu transmission to the wider community.

Mark Loeb, M.D., of McMaster University, Hamilton, Ontario, led the study. The research was funded in part by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and by the Canadian Institutes for Health Research.

Morbid Obesity as a Risk Factor for Hospitalization and Death due to 2009 H1N1

This document provides updated information on obesity and morbid obesity as risk factors for serious 2009 H1N1-related complications based on findings from recent studies.

How are obesity and morbid obesity defined?Body mass index (BMI) is a measure of body fat based on height and weight. Obesity is defined as a BMI of greater than or equal to 30 kilos per meter squared and morbid obesity is defined as a BMI greater than or equal to 40 kilos per meter squared. Among Americans 20 years and older, 28% are obese and 5% are morbidly obese.

Have obesity or morbid obesity been considered risk factors for serious flu-related complications in the past?The Advisory Committee on Immunization Practices considers that certain chronic health conditions place persons at higher risk of serious flu related complications, including asthma, diabetes and heart disease, and emphasizes the importance of vaccination in people with these health conditions. In the past, neither obesity or morbid obesity have been considered independent risk factors that would place people at higher risk for serious flu-related complications.

What has been learned from the 2009 H1N1 pandemic about obesity and risk of serious influenza disease death?During the 2009 H1N1 pandemic, early reports from the United States and abroad suggested that obesity was more frequent among persons hospitalized with 2009 H1N1 disease or who died following 2009 H1N1 infection.

Since that time, a number of studies have suggested that many 2009 H1N1patients tend to be morbidly obese. The study “Morbid Obesity as a Risk Factor for hospitalization and Death due to 2009 Pandemic Influenza A (H1N1) Disease,” published in PLoS ONE, sought to determine whether or not obesity or morbid obesity were in fact independent risk factors for serious 2009 H1N1-related complications, including death.

This study found that morbidly obesity persons have a higher risk of hospitalization for 2009 H1N1 infection compared to persons with normal weight. Data from this study also suggest that the risk of death following H1N1 infection may be higher for morbidly obese individuals.

What has been learned from the 2009 H1N1 pandemic about morbid obesity and risk of death?People who are obese or morbidly obese may be at a higher risk of dying from 2009 H1N1, even without any other previously recognized high risk conditions.

2009-2010 Influenza Season Week 9 ending March 6, 2010All data are preliminary and may change as more reports are received.

Synopsis:During week 9 (February 28 – March 6, 2010), influenza activity remained at approximately the same levels as last week in the U.S

174 (5.1%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.

All subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses.

The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.

No influenza-associated pediatric deaths were reported.

The proportion of outpatient visits for influenza-like illness (ILI) was 1.9% which is below the national baseline of 2.3%. Three of 10 regions (Regions 4, 7, and 9) reported ILI at or above region-specific baseline levels.

No states reported widespread influenza activity, five states reported regional influenza activity, Puerto Rico and six states reported local influenza activity, Guam, and 33 states reported sporadic influenza activity, the U.S. Virgin Islands and six states reported no influenza activity, and the District of Columbia did not report.

Pandemic (H1N1) 2009 - update 91Weekly update12 March 2010 -- As of 7 March 2010, worldwide more than 213 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 16713 deaths.

WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of information.

Situation update: The most active areas of pandemic influenza transmission are currently in Southeast Asia, however, lower levels of pandemic virus circulation persist in other parts of Asia and in Eastern and South-eastern Europe. In West Africa, limited data suggests that pandemic influenza virus transmission may be increasing in region. Of note, seasonal influenza B viruses have been increasingly detected in Asia and appear to be spreading westward.

In Sub-Saharan Africa, limited data suggests that on-going community transmission of pandemic influenza virus continues to increase in parts of West Africa, without clear evidence of a peak in activity. Increased detections of pandemic influenza virus have been observed among sentinel surveillance sites in several countries, including Senegal and Cote D'Ivoire, however, to date, data is limited regarding the spectrum of clinical severity of cases. Recent increases in influenza activity have also been reported in Rwanda. Much of eastern and southern Africa likely experienced an earlier peak in pandemic influenza activity during November 2009 and late summer 2009, respectively.

In South and Southeast Asia, pandemic influenza virus circulation persist in most countries, however, overall transmission remains most active in Thailand, especially since mid January 2010. Approximately half of all provinces in Thailand reported that greater than 10% of all outpatients sought care for ILI, and approximately 25% of all patients with ILI at sentinel sites tested positive for influenza. The current increase in the number of cases in Thailand remains well below an earlier period of peak transmission during June through September 2009. In Bangladesh, an increasing trend in respiratory disease was reported, however, overall influenza activity remains low. In India, influenza virus transmission persist at lower levels in the western region of India, while activity in other regions has largely subsided.

In East Asia, pandemic influenza activity continues to decrease or remain low as levels of ILI return to seasonal baselines in Japan and in the Republic of Korea. In Mongolia, a recent sharp increase in ILI activity was associated predominantly with a resurgence of circulation of seasonal influenza B viruses. In China, pandemic influenza activity has declined since peaking during November 2009, however, overall influenza activity remains elevated, largely due to an increase in the circulation of seasonal influenza B viruses.

In North Africa and Western Asia, overall pandemic influenza activity remains low in most places, with the exception of Iraq and Afghanistan, both of which reported regional spread of influenza with an increasing trend in respiratory diseases activity. In Afghanistan, a moderate impact on the healthcare system was reported in association with increased respiratory diseases activity. Although overall influenza activity remains low in Iran, all recent influenza virus detection have been due to seasonal influenza B viruses.

In Europe, overall pandemic influenza transmission continued to decline as low levels of pandemic virus continue to circulate in parts of eastern and south-eastern Europe. The overall percentage of sentinel respiratory specimens testing positive for influenza remained low (6.8%) but slightly increased compared to the previous week. Pandemic H1N1 2009 virus continues to be the predominant circulating influenza virus in the European region with the exception of the Russian Federation and Sweden where influenza B was reported as co-dominant or dominant.

In the northern and the southern temperate zones of the Americas, overall pandemic influenza transmission remained low as influenza virus continued to circulate at low levels. In Central America, Nicaragua and Honduras, reported slight increases in respiratory diseases activity, possibly due to an increase in school outbreaks; however, it is unclear to what extent the increases are associated with circulation of pandemic influenza virus. In Brazil, an increasing trend of respiratory diseases with low overall intensity was reported in association with regional spread of influenza virus.

In the temperate zone of the southern hemisphere, overall influenza activity remained low, with sporadic detections of pandemic and seasonal influenza viruses.

Although pandemic influenza virus continues to be the predominant circulating influenza virus worldwide, circulation of seasonal influenza B viruses continue to increase and spread across Asia, parts of Eastern Europe, and Eastern Africa, but most notably in China, Mongolia, Iran and the Russian Federation.

The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza. For more information on virological surveillance and antiviral resistance please see the weekly virology update (Virological surveillance data, below).

5 Things People with Disabilities Need To Know About the FluApril 8, 2010 10:00 AM ET

1. The flu can be serious for people with disabilities, if:you have health problems that make it hard for your body to fight off infections. you have lung problems, like asthma or bronchitis you have difficulty walking and moving around you are not able to stay away from people who may be sick with the flu

2. Plan what you will do if you or your caregiver gets the flu.Create a contact list of local family, friends, and local service agencies that can help provide care for you if you or your caregiver gets sick. Make sure that you know at least two ways of staying in touch with people: land-line phone, cell phone, text-messaging, or email. Ask your health care provider or pharmacist whether flu medicine (prescription and over-the-counter) is safe to take with your regular medication.

3. Call your doctor or clinic to get your seasonal flu vaccine and 2009 H1N1 flu vaccine and encourage others to do so as well, including caregivers and family members.

4. Take everyday steps to help prevent the spread of germs.Cover coughs and sneezes with a tissue. Throw the tissue in the trash after you use it. Stay away from people who are sick, or stay home if you are sick. Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. Avoid touching your eyes, nose and mouth. Germs spread this way.

5. Call your doctor or clinic if you get sick with a cold, cough, sneeze or fever. This could be the flu and you may need to take antiviral drugs. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight the flu. Antiviral drugs can make illness milder and shorten the time you are sick. They may also prevent serious flu complications.

H1N1: One year laterThis week marks one year since the H1N1 flu was first identifiedBy: Thomas R. Frieden, MD, MPH, Director, CDC

It’s been one year since 2009 H1N1 influenza surfaced and CDC kicked into overdrive to isolate and identify the virus, send vaccine candidate strains for vaccine production, distribute tools to help doctors in the United States and around the world diagnose the virus, and help craft a national response strategy to protect the American public from this pandemic virus.

The response included the urgent development of safe vaccines, their distribution and rapid administration by thousands of health care providers, and a national communications strategy to inform and instruct the American people about how to best protect themselves. We pushed to the limits of our current technology in these areas and were very effective. That success would not have been possible without the vital assistance of our state, local, and community partners.

The efforts of thousands of CDC employees and other healthcare professionals have helped reduce the number of illnesses, hospitalizations, and deaths from this virus.

As we enter spring and CDC, U.S. healthcare providers, and the American people gear up for the start of the 2010-2011 flu season, we must remain vigilant against a resurgence of 2009 H1N1.

At the same time, we must work toward enhanced disease surveillance, more timely vaccine availability, and stronger support for local health partners such as public clinics, schools, and other community institutions. We have much to do, but the past season has shown how effective our public health system can be when it is supported and mobilized.

CLINICAL tests were never carried out on the latest seasonal flu vaccine - a first-time combination of seasonal flu with the feared swine flu H1N1 - that has left a baby girl fighting for her life in a Perth hospital and sparked fits, fevers and vomiting in up to 60 toddlers across the country.

Health officials were last night trying to determine what had caused the reactions in the children, mostly in Western Australia.

The country's chief medical officer, Jim Bishop, yesterday ordered doctors in all states to stop giving the flu vaccine to children under five.

Professor Bishop said non-swine flu strains in the vaccine may have caused the reactions.

For the first time in the world, the flu shot rolled out in Australia last month combined two strains of seasonal flu, as well as H1N1.

Professor Bishop said the Panvax vaccine - the swine flu jab - was "safe", but said the combined flu shot had been suspended for young children as a "precautionary measure" pending investigation by the Therapeutic Goods Administration, which approved its use last month.

Panvax was tested on 400 children before its release last year, but the combined shot was not subjected to any clinical trials.

CSL, which manufactures both vaccines, has stopped distributing children's doses nationally "to reduce the risk of inadvertent administration in this age group".

One angry West Australian mother, who only wanted to be identified as Sharon, said if officials had acted earlier, the one-year-old girl in critical condition in hospital may never have become sick.

Sharon had three of her four children vaccinated two weeks ago and all three needed hospitalisation after suffering from fevers, vomiting and fits. She said it was a frightening experience after her three-year-old, Alivia, turned purple and began shaking. One of her one-year-old twins, Lateesha, later started convulsing.

Peter Richmond, associate professor at the University of Western Australia's school of pediatrics and child health, said the vaccine was not subjected to trials.

"As with each year's seasonal influenza vaccine, this year's seasonal influenza vaccine isn't subject to specific trials in children before it's used," he said.

He added that three trials of different combinations of seasonal flu vaccines had been conducted in children and no concerns had been raised.

Professor Robert Booy, the director of clinical research at the National Centre for Immunisation Research and Surveillance - who helped supervise the swine flu trials - said the combination of flu strains could not be the cause of the problems.

A FAMILY is in mourning after their toddler unexpectedly died less than 12 hours after receiving a seasonal flu vaccination.

Two-year-old twin Ashley Jade Epapara had been "perfectly fine" before dying at her Upper Mt Gravatt home, on Brisbane's southside, on April 9. Parents David and Nicole are shattered by the mysterious death of their baby girl. "It's dreadful, it's a very hard time," Mr Epapara said yesterday.

National health authorities have ordered doctors to stop giving seasonal influenza vaccinations to children under five after dozens of serious reactions, including convulsions.

Ashley's death is being investigated by police and the office of the coroner. A spokesman for Brisbane coroner John Lock confirmed yesterday that a report was being prepared.

Mrs Epapara told The Sunday Mail that "tests are being carried out" on her little girl. But the young mother didn't want to comment further as she began shaking and her eyes welled with tears. Ashley's twin sister, Jaime, also received the flu jab at the same time and is believed to have been vomiting the night before her sister died.

Asked whether he or his wife thought the influenza vaccine had anything to do with their child's death, Mr Epapara said: "It's very coincidental."

More than 45 children experienced convulsions and fever, with some having to be hospitalised in intensive care after receiving the vaccine in Western Australia.

Queensland chief health officer Jeannette Young confirmed 15 children in Queensland had been recorded as having an adverse reaction to the vaccine.

Australia's chief medical officer Professor Jim Bishop said in a statement that the West Australian events were being "urgently investigated by health experts and the Therapeutic Goods Administration".

The World Health Organisation last year said a "small number of deaths" had occurred in people vaccinated for influenza, with 65 million people vaccinated globally.

AUSTRALIAN health authorities have announced a nation-wide ban on children under 5 being vaccinated for the seasonal flu.

The move comes after Western Australian health authorities reported a batch of children under five suffered high temperatures and convulsions after being vaccinated.

Australia's chief medical officer Jim Bishop this morning said the recommendation not to give the vaccine to young children was a “precautionary measure”.

"Until we know more we've suggested that we don't use that [seasonal flu vaccine] for the moment in children under five," he said on ABC radio this morning.

"I'm advising all doctors today not to use it until we know a bit more.

"This may be part of the normal pattern once we see the whole picture, or it may be more than we would expect. Therefore I just think it's wise and precautionary not to use it in children under five.

“The first thing is to find out if this is an aberration due to just an aggregation of cases or is something important.

So far health authorities in other states have not reported any problems, however Professor Bishop says that could be because WA has a particularly strong program on encouraging young children to be vaccinated.

Prof Bishop said the van did not extend to the swine flu vaccine that could still be given as a separate injection.

He said other groups at high risk of flu, particularly the elderly and pregnant women, should continue to be vaccinated for the seasonal flu.

Prof Bishop says one of the first steps was to identify whether the problem was associated with particular batches or was a wider problem.

Coroner unable to find cause of death of tot who had flu jab day before she died

* Rosemary Odgers * From: The Courier-Mail * April 27, 2010 1:01PM

AN autopsy has failed to find a cause of death of a two-year-old girl who died a day after receiving a flu jab.

Ashley Epapara was found dead in her cot at her family's Mt Gravatt home, in Brisbane's southeast, the morning after she and her twin sister were inoculated by the family GP. Her father says she was a perfectly healthy little girl.

Health Minister Paul Lucas and Queensland's chief health officer Jeannette Young have told a press conference it was too early to say whether a flu shot contributed to Ashley's death.

More tests will be needed to determine if she died from having a seasonal flu vaccine, Dr Young said.

The Queensland coroner is investigating the cause of her death.

``It's too early at this stage to say that the vaccine caused this child's death or what indeed caused this child's death,'' she said.

Mr Lucas has come under fire after it was revealed Queensland Health assured parents the seasonal flu vaccination was safe despite being warned it may have contributed to Ashley's death.

Mr Lucas admitted on Monday he had been asked about the death and had ordered a QH investigation on April 9.

Dr Young had previously maintained that QH had never been "advised of, or were aware of" a death "allegedly" relating to this year's seasonal vaccination.

Today, they defended their response to the case.

Dr Young said she had done everything possible to find out more information about the death after scant details were provided by the media on April 9.

However, she said, without a name that proved impossible to follow up.

She said that once the media provided a name to her on the weekend she was able to carry out a more thorough investigation.

She said Queensland Health staff had contacted the girl's family on Tuesday morning.

Mr Lucas said he had faith in Dr Young's response to the case and in QH's response overall.

He said as it was a private GP who administered the vaccination, it was up to the GP to notify authorities of the death.

HEALTH authorities are increasingly worried that Queensland is heading for a horror flu season.

Doctors were already expecting a "double whammy" flu threat, with the return of swine flu and two more conventional strains expected to circulate.

Now the number of people requesting flu vaccinations has plummeted after the shots were banned for children aged five and under.

GPs are reporting a 50 per cent drop in requests for the seasonal flu vaccine, which is safe for those over the age of five and protects against swine flu, or H1N1, influenza B and A:Perth.

The swine flu vaccination remains safe for all ages.

The Therapeutic Goods Association is investigating whether the flu vaccine may have caused the death of Brisbane two-year-old Ashley Epapara, and authorities are yet to get to the bottom of a vaccine scare in Western Australia, with tests so far showing no signs of abnormalities.

There have been hundreds of cases of children suffering adverse reactions to vaccines, including febrile convulsions, fevers and vomiting.

Australia's chief medical officer Jim Bishop said it was possible a spike in cases of fever and convulsions among young children in WA could simply be linked to the higher number of vaccinations performed there.

Australian Medical Association Queensland president Mason Stevenson said ongoing "unnecessary paranoia" about flu vaccinations could result in an "abysmally low" vaccination rate this year.

"This has come at the worst time when we anticipate the second wave of the human swine flu pandemic to hit Australia," he said.

"We have 230 intensive care beds in Queensland, and it would only take an epidemic not much worse than last year's to max out our ICU beds."

Dr Stevenson said a "double whammy" flu threat would hit all age groups this year.

"Vaccination rates remain low, and there are as many as three circulating strains in the same year, with swine flu a grave risk to the young and middle-aged, and the two seasonal flu strains the greatest risk to the elderly," he said.

"All this will put immense pressure on our hospital system to provide what is life-saving care in some cases."

Flu expert Alan Hampson, chair of the Australian Influenza Specialist Group, said he feared any drop in vaccinations would cause what would otherwise be preventable deaths.

Just last week, three Queenslanders were in intensive care with swine flu, and Dr Hampson said he expected H1N1 to remain dominant this season.

"Last year about a third of the people who died and a third of the people who finished up in intensive care . . . were normal, healthy younger people," Dr Hampson said.

He said every year about 250 Australians died from influenza, and the disease indirectly killed a further 2500.

"Influenza predisposes people to pneumonia, it can also precipitate heart attacks and strokes, and it puts the blood chemistry of diabetics right out of control."

Dr Hampson said influenza was often referred to as the "chameleon of viruses".

"That's how it escapes the immunity that we develop previously from infection or vaccination, and why its such a successful virus."

Dr Hampson said there was still enough time for people to be vaccinated, with flu season to kick off in June and peak somewhere between July and September.

YW Mere and Klaas. Yes we are in autumn (fall) and heading for winter. There has not been a lot in our media as yet about another H1N1 outbreak, but my GP told me they have already seen several cases at her clinic. I will update this thread if anything is published about this infection Australia wide.

There has not been any more children succumb to the vaccine although there have been several hundred affected in at least two of our states. It has been banned Australia wide for children under 5 years. It is presently believed that it could be one of the other two flu vaccines, that are combined with the H1N1 vaccine, that is at fault.

Logged

....And at night the wond’rous glory of the everlasting stars.. A.B (Banjo) Paterson

A TASMANIAN company has used seaweed to develop a groundbreaking treatment for swine flu.

Laboatory trials over the past nine months using a compound in undaria seaweed harvested from waters at Triabunna, of Tasmania's East Coast, to inhibit the virus have been positive.

It promises to be the first major naturally derived breakthrough to treat swine flu.

Tasmanian scientist Helen Fitton yesterday announced the breakthrough was a significant step towards protecting the world against swine flu.

"With swine flu already becoming resistant to some other antiviral agents, we believe that the extract - known as Maritech 926 - offers a potent, natural alternative which supports the immune system against viral attacks," Dr Fitton said.

It takes about 200kg of undaria seaweed and highly sophisticated techniques to produce 1kg of pricey powder.

The biotechnology company Marinova, based at Cambridge, has been researching this compound, which is sugar based, for nearly eight years.

"In December new results found that it prevents the H1N1 virus from entering the cell and multiplying," Dr Fitton said.

"Once you reach the effective concentration the virus is unable to enter cells - and only millionths of a gram (of Maritech 926) is needed to be effective as an inhibitor to H1N1.

"This ingredient is ready now to be incorporated into a product to prevent H1N1 from entering your body.

"The compound protects the seaweed itself from marine toxins and pathogens and similarly protects against the type of viruses that affect human cells.

"It has also shown very good antiviral activities against a range of influenza strains, HIV and herpes."

Marinova managing director Paul Garrott said the product, which is environmentally sustainable, is at a commercially viable place right now.

Mr Garrott hopes that pharmaceutical companies will take deliveries soon in order to begin human trials.

The next step would be to manufacture it on a large scale, he said.

Scope also exists for the compound to be included in other pharmaceutical and medical device applications.

"It is ready to go. The commercial potential is enormous in nutritional supplements, hand washes and nasal delivery products which target the spread and prevention of viral conditions," he said.

"We believe that this is the only natural certified organic substance that has this level to inhibit swine flu.

"It is not a substitute for the swine flu vaccination, rather it is a first defence against swine flu.

"It is conceivable that there could be a product on the market within months."

Dr Fitton said there is a growing market for people who want to use completely natural products.

Dr Fitton said Maritech 926 is stable, water soluble and has an extended shelf life that makes it suitable for inclusion in a wide range of delivery systems, like hand wash.

The company has filed a patent for its breakthrough seaweed extract.

Lab tests were performed under contract by the National Institute of Allergy and Infectious Diseases (NIAID), which is part of the National Institutes of Health (NIH) in the US.